I'm seeing the phyciatrist tomorrow and am nervous, when I last spoke to you I held back a little because I don't wanna seem crazy or looking for attension. I also don't wanna be sent to a clynic. What I did hold back on was the suicidle thoughts I have them often and google how to do it but I won't do but I keep on playing on the idea

Customer:

Should I tell him everything as bad as it may be? Also I don't want him to think I'm looking for attension or something I really wanna be helped and become the person I was before.

Dr. Z :

I am so sorry that you have been thinking these thoughts, I can understand how that would distress you greatly. May I ask when did these suicidal thoughts start to occur?

Customer:

I've been down for a few weeks once or twice about three weeks ago and now every day. But I won't do it.

Dr. Z :

Okay, well because you will not actually commit the act, but you are having thoughts then your psychiatrist may change you medications most likely to help lower these thoughts of suicide. But I do not think you will be sent to a clinic, unless you want to. So I think telling your psychiatrist would be wise. I would mention that you have been getting depressive and thoughts of hurting yourself, but they are not severe enough for you to act on at this time. That will show that you are still in control and that being sent to a clinic is not necessary for you

Dr. Z :

I remember that you were on the Lamictal, are you on any other medications?

Customer:

Just valium it helps a bit but not much. Today I woke up at 3am and just lay here all sad. Anyway you think I must just tell him everything that's wrong. Another question do you think I can become my old self and if yes when?

Dr. Z :

Okay, well your psychiatrist may switch you to an antidepressant to help with your symptoms then. I do believe that you will be able to be like your old self with the medication and the CBT techniques that I showed you last time we spoke, but as for when I cannot say for certain. Unfortunately the use of medications are a trial and error approach, where everyone reacts to certain medications differently. The goal of the psychiatrist is to find the right medication and combination of medications that work well for you and sometimes that takes time. So as for when you will feel like yourself again, I cannot say for certain. But I can promise you that I nor your psychiatrist will give up trying to help you

Customer:

Another thing I've lost 10kg's 22 pounds in the last six weeks and I wasn't fat although I have not been eating much. To tell you the truth I actually hope it is related to the head trauma and it's a chemical thing that can be fixed don't wanna be crazy

Dr. Z :

The eating less could be a sign of depression as a result of the head trauma. It may take some time to find the right combination of medications to help with your symptoms. So I think your psychiatrist may add an antidepressant to your Lamictal to help with these symptoms.

Dr. Z :

I would recommend 10-20mg of Escitalopram if your psychiatrist does want to add an antidepressant to you medication regimen

Customer:

Thanks Doctor will let you know how it goes and rate you as excerlent

Dr. Z :

I hope it all works out well for you and please if you have any other questions or concerns, feel free to contact me at anytime.

Customer:

Sorry last question if you can remember what I told you about the lamictol and craniotomies and now epilepsy , partial what would your diagnosis be?

Dr. Z :

I do remember that you take the Lamictal for the seizures, but it is supposed to help with depression to as an added bonus. I think that your seizure disorders may caused a neurotransmitter imbalance and that you have a separate depressive disorder. Your psychiatrist can add a SSRI or SNRI antidepressant to your Lamictal with no major side effects and this should help re-balance you and lessen those depressive symptoms.

Dr. Z :

That would be my diagnosis for you, and that is most likely why you were referred to the psychiatrist because this is a separate depressive disorder.

I will tell you that...the things you have to go through to be an Expert are quite rigorous.

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